Lupus is far less common in men, and when it occurs it is often diagnosed late because it is not suspected. Men are more likely to present with renal, haematological or serositis features than with classic rash and arthralgia.
A low threshold for checking antibodies avoids delay.
- Check ANA and urinalysis in a man with unexplained serositis, cytopenias, proteinuria or thrombosis.
- Think of drug-induced lupus — hydralazine, procainamide, isoniazid and anti-TNF agents.
- Look for antiphospholipid antibodies after an unexplained clot.
- Screen for renal involvement at diagnosis and at every review, as nephritis is common in men.
Why it matters
Diagnostic delay in men often means organ involvement is established by the time lupus is named.
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